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  • Meeting abstract
  • Open Access

138 Relationship between coronary calcification and endothelium dependent coronary vaso-reactivity in asymptomatic diabetic patients without overt coronary artery disease

  • 1,
  • 2,
  • 2,
  • 1,
  • 1,
  • 3,
  • 2 and
  • 2
Journal of Cardiovascular Magnetic Resonance200810 (Suppl 1) :A39

https://doi.org/10.1186/1532-429X-10-S1-A39

  • Published:

Keywords

  • Myocardial Blood Flow
  • Coronary Calcification
  • Vascular Territory
  • Signal Intensity Curve
  • Asymptomatic Diabetic Patient

Introduction

The relationship between coronary calcification and endothelium dependent coronary vaso-reactivity in patients with diabetes mellitus is poorly understood.

Purpose

We hypothesize that endothelium dependent coronary vaso-reactivity; in asymptomatic diabetic patients without myocardial ischemia is impaired in vascular territories with coronary calcification.

Methods

We studied 23 (mean age 63 ± 10, 19 M, 4 F) patients with type II DM, without history, symptom or ECG evidence of CAD. The subjects underwent 1-day rest-stress adenosine nuclear stress test, assessment of coronary calcification by EBCT and absolute measurement of myocardial blood flow at rest (MBF-R), and following cold-water hand immersion for 1 minute (MBF-C). All imaging studies were performed within 24 hours. Flow measurements by CMRI was performed using saturation recovery TurboFLASH imaging sequence: TR/TE/TI/FA = 2.9 ms/1.3 ms/90 ms/6°, data matrix 128 × 70, and usual voxel spatial resolution 3.5 × 1.9 × 8 mm3. Contrast dose was 0.05 mmol/kg (Omniscan, Amersham). All scans were processed in a blinded fashion. Using Medis software (Leiden University, the Netherlands), basal, mid-cavity and apical slices were divided into 6 equal transmural sectors. After correction for coil sensitivity variations, model independent deconvolution of myocardial signal intensity curves in the sectors, with blood pool signal intensity curves was performed. MBF-R and MBF-C in mls/g/min were determined. Endothelium dependent perfusion reserve (MPR) in these sectors were calculated as the ratios of MBF-C to MBF-R in each sector. The sectors wre subsequently grouped based on standard coronary vascular distribution.

Difference between means of two groups of patients was calculated using Student's t-test while One-way ANOVA model was utilized to compare means amongst three groups. P-value of < 0.05 was considered significant

The vascular sectors were stratified into 3 groups (A, B, C) based on the Agatston calcium score of their respective coronary arteries from 0, 1–100, 101–400 respectively.

Results

MPR in groups A B and C were 1.22 ± 0.4, 1.11 ± 0.3 and 1.01 ± 0.24 respectively (p = 0.03 for A vs (B and C combined)) (See Figure 1). We also compared mean differences in vaso-reactivity for Groups A, B, and C separately to assess whether a graded relationship exists between vaso-reactivity and the extent of calcification. This model was not significant (p = 0.19).
Figure 1
Figure 1

Endothelium-dependent perfusion reserve(MPR), as a marker for coronary vaso-reactivity, is impaired in coronary arteries with any amount of calcification. MPR was calculated by measuring myocardial blood flow during rest and during immersion for 1 minute in cold-water by Cardiac MRI.

Conclusion

Endothelium-dependent vaso-reactivity is impaired in vascular territories with any amount of calcification compared with vascular territories without calcification. We do not have evidence to support a quantitative relationship between endothelium dependent coronary vaso-reactivity and the extent of calcification.

Authors’ Affiliations

(1)
New York Hospital Medical Center Queens, Flushing, NY, USA
(2)
Saint Francis Hospital, Roslyn, NY, USA
(3)
SUNY Downstate, Brooklyn, NY, USA

Copyright

© Akinboboye et al; licensee BioMed Central Ltd. 2008

This article is published under license to BioMed Central Ltd.

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